Studies to improve the effectiveness and efficiency of platelet transfusion therapy are proposed with emphasis on transfusion of single-donor concentrates to alloimmunized patients. A comparative study of various methods for detection of platelet antibodies by indirect testing utilizing different methodologies will be undertaken, and these will be evaluated for sensitivity, specificity and feasibility of being applied on a large scale. The applicant will also undertake the analysis of information on 2,500 single-donor platelet transfusions performed previously at The Blood Center of Southeastern Wisconsin in an attempt to gain new insights into requirements for donor-recipient antigen compatibility and other causes of the variable responses observed in many patients. In subsequent studies, the importance of circulating immune complexes in affecting the response of patients to single-donor and random-donor platelets will be investigated, and a prospective study to determine whether reduction of the leukocyte content of platelet concentrates reduces or delays alloimunization will be implemented. Finally, platelet utilization patterns in southeastern Wisconsin will be studied and strategies to improve platelet transfusion practices will be tested on a controlled basis.